Provider Demographics
NPI:1790652006
Name:HOPKINS, STEPHANIE RENAE
Entity type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:RENAE
Last Name:HOPKINS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:632 OLD PRATER RD
Mailing Address - Street 2:
Mailing Address - City:MARION
Mailing Address - State:VA
Mailing Address - Zip Code:24354-4197
Mailing Address - Country:US
Mailing Address - Phone:276-620-4630
Mailing Address - Fax:
Practice Address - Street 1:791 FORT CHISWELL RD
Practice Address - Street 2:
Practice Address - City:MAX MEADOWS
Practice Address - State:VA
Practice Address - Zip Code:24360-4139
Practice Address - Country:US
Practice Address - Phone:276-637-6641
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-10-21
Last Update Date:2025-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0001314733163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse